Concierge Medicine: Having a Doctor on Demand

Should you drop $1,500 or more a year for a physician who truly pays attention to you? Here’s the lowdown on concierge medicine

by Cathryn Jakobson Ramin

Photograph: Emiliano Ponzi

For the next hour, we talked about every aspect of my personal and professional life, including the continual stress involved in meeting the deadline for my next book. She understood how difficult it is for us laypeople to navigate the health care system and recognized that it was her job to coordinate care. First, she’d collect all my medical records, bringing the findings of my OB-GYN, my breast surgeon, my orthopedist, my physical therapist and my endocrinologist under one roof. She would study my medical history in detail, and then we would move forward. She would select all my specialists and stay in touch with them. She’d also deal with my insurance provider on preauthorizing any scans, tests or procedures I required. If a specialist ordered a test, or a battery of them, she’d use her judgment, making certain they didn’t duplicate evaluations I’d already had. She would remind me, five times if necessary, to get my mammogram and not dare blow off my next colonoscopy when I turned 60. If I needed to see her—this wouldn’t happen often, because so many things could be handled over the phone—same-day appointments were typical and would never cost more than my $30 co-pay.

As I climbed into my car, I realized I felt cared for in a way that often eludes women in midlife, when the demand to meet the needs of other people—spouses, parents, children and bosses—is unceasing. The annual fee was starting to seem like a sound investment. I needed a partner in health care, a cheerleader who would refuse to let me put myself on the back burner. While I can’t guarantee that every concierge doctor makes patients this comfortable, with Dr. Fong I felt as if I’d planted the seeds of a special and enduring relationship.

From Practicing Medicine to Practicing Wellness

About nine weeks after I signed on with Dr. Fong, I got this article assignment and informed her I was writing about my health care experiences. I don’t believe that affected her treatment of me, but in any case, all the other new concierge patients I interviewed were similarly positive. Sherise Beale, who lives near Philadelphia, said she started having leisurely conversations with her doctor of eight years after she transitioned to a retainer practice: “I’d had migraines for the entire time she was my doctor, but after she went into concierge practice, she could adjust my meds when she needed to without my having to wait three months for an appointment.”

Other patients commented on a shift in emphasis from reactive care to preventive care. Tracey Watson, an attorney who serves as the general counsel for the Utah Education Association in Salt Lake City, went to Dr. Beth Hanlon’s traditional medical practice after it opened in 1993. “It was extremely hard to get an appointment, and when I did, my visits lasted 10 minutes,” Watson recalls. In the months since Dr. Hanlon made the transition, that has totally changed. “It went from ‘Dr. Hanlon, I’m sick, please make me better’ to an opportunity to work with me on long-term goals,” Watson says.

The opportunity for follow-up is particularly useful when it comes to changing risk factors such as smoking and being overweight. Dr. Hanlon recalls a young woman who had been her patient for years before the transition: “Every year she came back five pounds heavier, and every year we had the same discussion about her need to lose weight.” Last April, after examining the woman for the first time in the new concierge practice, Dr. Hanlon told her to come back in three months “10 pounds lighter.” To the physician’s delight, when the woman returned in June, she’d lost 23 pounds. “It was very exciting,” Dr. Hanlon recounts. “She’d quit eating fast food and drinking sweet soda. Her cholesterol had improved, and she was no longer on the brink of diabetes. What changed is that with my concierge practice, I could sit down with her and come up with a definitive plan.”

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Comments

Great article and great speaking to you about this. I posted it on www.facebook.com/healthcareforless where you will find more tips like this and how to save on your healthcare. A "good doctor" will be harder and harder to find if things continue to go on as they are in healthcare.....oh and watch out for those "online reviews"....doctors are now hiring bloggers to get their ratings up! So if you are going concierge, choose wisely!